Flu season arrived early in Orange County. By the beginning of October, people were already being sickened by influenza, a disease that kills thousands of Americans every year, said Irvine pediatrician Marnie Baker.

“It’s unusual to see influenza surface at this time of year,” Baker said. Normally, California’s flu season doesn’t get underway until December.

That early arrival is one reason why health officials expect what could be a particularly bad flu season, Baker said. The other reason is that the Southern Hemisphere, which gets its flu season before ours, had a rough year, dominated by the H3N2 strain of the virus. H3 strains are typically associated with tougher flu seasons.

Doctors are already concerned about whether enough children will be immunized.

According to a July report in the journal Vaccine, immunization rates dropped a little last year after the U.S. Centers for Disease Control and Prevention recommended that children stop getting the nasal mist form of the vaccine. New studies had shown that the mist, though painless, also was virtually useless. And that meant children needed shots — an ordeal some parents didn’t want to face.

“It’s difficult for parents to see their children in pain,” Baker said. “And it’s difficult when every time a child is going to the doctor’s office, there’s a shot involved and then there’s this association with shots and doctors’ visits.”

The good news is that parents can ease their children’s anxiety and even reduce their pain. Baker has some helpful suggestions; others come from a study published in the Canadian Medical Association Journal, in which researchers looked at whether various recommendations were actually borne out by the evidence.

Be honest

Both Baker and the CMAJ study emphasize how important it is to be straightforward — if asked — about whether the shot will hurt. Once children feel betrayed by a lie, their fear will be multiplied in the future, not just about shots but for anything that parents tell them won’t hurt.

Be positive, but don’t make a fuss about it

If you do need to talk about the doctor’s visit weeks or days beforehand, telling young children that they’ll be getting their Superhero Protection might help alleviate anxiety, Baker said.

But before they receive their vaccination, they need to know what to expect. For those old enough to understand, it can be useful to explain briefly why vaccination is so important, but don’t overdo it.

The Canadian study found that reassurances, apologies and long explanations actually increased children’s perception of pain rather than reduced it. Humor works better than earnest lectures.

For infants, breast-feed

Breast-feeding during and right after vaccination goes a long way toward soothing a small child. Part of that is the cuddling and skin-to-skin contact, the Canadian study found.

But there’s also a physiological component: the sweetness in the milk releases natural pain reducers. The study suggested that for babies that aren’t breast-fed, a bit of sugar water a minute or so before the shot has a similar effect. It’s something to discuss with your child’s pediatrician.

Distraction, under certain circumstances

Baker said she’s found that distraction — a sticker, a new toy, a fun video played on a tablet or smartphone — can reduce anxiety before a shot and quickly get a child’s mind off the temporary pain of the pinch.

The Canadian study found that it can also be useful during the vaccination, with one big caveat: Distractions selected by the parents didn’t work. When children got to choose their own distractions, the tactic was much more effective.

Don’t have your child lie down

Children felt less pain when were sitting upright, according to researchers.

Try some physical pain relief

If your child seems very sensitive to the pain, a topical anesthetic applied to the skin beforehand works well, the study found.

For children 4 and older, researchers suggest asking the health care provider to stroke the skin at the injection site immediately before the shot. Arrange these plans with your doctor beforehand.

Above all, doctors and other health experts say, the temporary discomfort of a flu shot is no reason to avoid immunization. The flu vaccine isn’t protecting your child against the everyday colds-and-flu viruses, but influenza, a potentially serious disease that kills thousands of people in this country every year.

“Flu is the number one cause of vaccine-preventable deaths in the United States,” Baker said. “Children and the elderly are at highest risk of complications from the flu, and most of those who die from the flu are not vaccinated.” That’s an important piece of information for a disease that killed more than 100 children in the country last year.

“About half the kids who die from the flu were perfectly healthy kids beforehand, with no underlying medical problems,” Baker said.

It takes two weeks for the flu vaccine to take effect, she said. A wait-and-see approach won’t cut it; if your kids haven’t received this year’s shot, now’s the time to make an appointment.

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